Comparison of Immediate Changes in Cervical Range of Motion Following Cervical Extension and Downslip Mobilizations.

June 14, 2026 updated by: Kim Ennis, Missouri State University

Cervical Rotation Range of Motion Improvements Following Cervical Extension vs Downslip Mobilizations

The purpose of this study is to compare the efficacy seated cervical extension glides vs supine downslip glides, on both cervical rotation range of motion and patient comfort. Information gathered from this study may be used to help clinicians determine the most beneficial methods of cervical mobilizations as a rehabilitation tool.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Subjects were randomized to either the Downslips group or the Seated AP Extension Glide. Prior to and immediately after mobilization, bilateral cervical rotation range of motion measurements were taken in seated using the Cervical Range of Motion device (CROM) which has been shown to have good validity and reliability. The starting sides of both cervical spine mobilizations were chosen at the start of data collection. After that, both therapists alternated the side to begin the mobilization with each new subject. Each mobilization was performed 5x40" with a twenty second rest between. All five mobilizations are performed first on one side, then the contralateral side in the same manner, prior to the subject returning to the seated position for retesting of their cervical rotation range of motion with the CROM. The same researcher performed the CROM measurement pre- and post-mobilization rotational testing to reduce interrater error. Following the final CROM measurement, the subject was then asked to rate their perceived comfort with the technique using a modified Visual Analogue Scale, with 0 being no pain and 10 being the most uncomfortable.

The downslip mobilization is completed in supine, with the practitioner positioned at the patient's head. The practitioner places their second metacarpophalangeal joint of the mobilization hand on the articular pillar of C2 while the stabilizing hand is on the occiput allowing for motion to occur.

Mobilization will be in an direction that is caudal and dorsal towards the subject's contralateral hip for 5x40" with a 20" rest in between. The supine downslip mobilization will be performed by the same therapist bilaterally for all subjects; this therapist has more than thirteen years of clinical experience with advanced manual therapy training. The Seated AP Extension mobilization is completed with the subject(s) seated in the Frankfort neutral position. The therapist starts by palpating the articular pillar. The stabilizing hand is placed on C3's lamina, applying a force perpendicular to a line through the oribita to block the caudal segment. The therapist's mobilizing hand will be supinated so that their lateral 5th metacarpal is on the lamina of C2. The subject is then brought into extension and rotation to the C2-3 segment and a caudal-dorsal mobilization is applied respecting the cervical spines facet joint orientation of 45 degrees for 5x40" with a 20" rest in between. The Supine AP Extension mobilization will be performed by the same therapist bilaterally for all subjects; this therapist has more than thirteen years of clinical experience with advanced manual therapy training.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
128

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • United States
    • Missouri
      • Springfield, Missouri, United States, 65810
        • Recruiting
        • Missouri State University - Physical Therapy Clinic
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • healthy individuals
  • 18-45 years of age.

Exclusion Criteria:

  • current or previous history of neck pain;
  • cervical spine instability;
  • history of cervical spine surgery;
  • neurological issues;
  • contraindications to mobilization including fractures, coagulation issues, and osteoporosis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Cervical Downslips
Other: Cervical Downslip Mobilization
Mobilization in supine on the C2-3 articular pillar in a direction that is caudal-medial-ventral.
Experimental: Cervical Extension Glides
Other: Seated Cervical Extension Glide
Mobilization of C2 on C3 in a direction that is dorsal, lateral, and caudal.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Time Frame
Cervical Range of Motion
Time Frame: Immediately following mobilization
Immediately following mobilization

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Missouri State University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 12, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 28, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 28, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 11, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 14, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 18, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 18, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 14, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • IRB-FY2026-122

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

We will de-identify the individual participant data to share our primary outcome measurement of pre- and post-mobilization cervical range of motion.

IPD Sharing Time Frame

This information will be available until statistical analysis has been completed by October 2028.

IPD Sharing Access Criteria

Other faculty researchers including: Dalton Burke, Mike Rider, Brent Denny, Blaise Burgeois, Bob Salvatori, Hazel Anderson. They will be able to access it on a Dropbox folder that is private for anyone without access to the link.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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